INTRODUCTION The purpose of this study is to determine the prevalence of obesity and to compare the associated risk factors between the adolescent children living in rural and urban areas. MATERIALS This cross-sectional study conducted among 3,918 high school students getting education in the city centre and rural areas of Eskisehir. A specially designed questionnaire form included questions about socio-demographic characteristics as well as cardiovascular risk factors including smoking status, diet habits (breakfasting, consumption of sugar-sweetened beverages and fruit and vegetable consumption), physical activity and time spent on computer and/or television. RESULTS The prevalence of being overweight was 10.4% and 12.2% and the prevalence of obesity was 7.9% and 11.3% in rural and urban areas, respectively. In urban areas, being overweight was accompanied by prehypertension (OR=2.3, 95% Cl 1.6-3.3), hypertension (OR= 2.3, 95% CI 1.6-3.2), and family history of cardiovascular disease (OR =1.3, 95% CI 1-1.7), and obesity was accompanied by prehypertension (OR= 2.3, 95% CI 1.6-3.3), hypertension (OR=3.9, 95% Cl 2.9-5.3), excessive use of computer/TV (OR=1.3, 95% CI 1.1-1.7), having no breakfast (OR=1.3, 95% CI 1.1-1.7), physician-diagnosed diabetes mellitus (OR=4.2, 95% CI 1.3-14.1) and consumption of sugar-sweetened beverages (OR=0.6, 95% CI 0.5-0.8). In rural areas, although the variables accompanying being overweight were parallel with those in urban areas, obesity was only associated with prehypertension (OR=6.1, 95% CI 2.6-14.1), hypertension (OR=22.1, 95% Cl 9.9-49.3) and family history of cardiovascular disease (OR=1.6, 95% CI 1.1-2.6). CONCLUSION Risk factors may differ in the adolescents from rural and urban areas. It is important in overweight and obese children to assess the family history of cardiovascular disease, blood pressure and blood glucose, to ask about the habit of regularly breakfasting, and to evaluate time spent on computer/TV. As in urban areas, environmental regulations also become important in rural areas. Appropriate social activities for children to spent more time outdoor, e.g. in parks or playgrounds, are important in urban as well as in rural areas.